Under The Knife

Surgery Surge

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There's simply no night in baseball like Newberg Night in Arlington. It was slightly cooler (96 vs 107 last year), but the crowd was as big and as passionate as ever-350 people packed in to hear Kevin Goldstein and I be the opening act for Jon Daniels. Daniels was as candid as any general manager can be and didn't dodge any questions, even when fans reminded him of a "not so great" trade from the past. No other GM that I know of takes 90 minutes of questions (though a couple have taken 30 at some of our Pizza Feeds). Interestingly, Daniels was occasionally fiddling with his Blackberry while taking questions; he was actually putting Ian Kinsler on the DL and activating KG's mancrush, Neftali Feliz. It's pretty amazing what you can do with a phone these days. At the end, the applause was thunderous. Jamey Newberg didn't build a web site, he built a community. He didn't do it as a feature on a long list, but found a place where passionate fans found a home. Other writers and organizations, including right here, should take a lesson from Newberg and his readers. Memphis, Pittsburgh, and Indy are upcoming events that I'll be at, but I'd love to do more if someone (or some team) would like. Powered by a great night of baseball, on to the injuries:

Brandon Webb (10/4)
Webb had his shoulder 'scoped, and the results are both good and bad. Most of it was good and available in the release-there was no tear in the labrum, and the surgery ended up being a "clean-up." The surgery performed by Rangers team doc Keith Meister did focus on the labrum, which was frayed and not torn, but it also involved a general check and cleanup of the other structures. That there was a symptomatic problem with the labrum is bad, but it was minimal and is the type of issue from which pitchers do come back. He'll be in a rehab program immediately, and throwing by mid-September. There was a subtle announcement that Webb would be spending his offseason in Phoenix, a good indication that the D'backs expect to pick up Webb's option. It was a lost season for Webb and for the Snakes in '09, but '10 could be a lot different.

Edinson Volquez (10/4)Scott Rolen (8/5)
It was a busy day for surgeons, as Tim Kremchek had to go into Volquez's elbow. As expected, Volquez had a torn UCL, which was replaced in a Tommy John procedure. What wasn't expected was the flexor mass problem that was revealed, which multiple sources described as either "shredded" or "ruptured." The Reds say they expect Volquez back in 12 months, a very specific timetable which surprised many Reds watchers. Normally, the Reds estimate 9-12 months, so was the full 12 an indication of thinking that the flexor issue would keep him from hitting the aggressive end of the timetable, or is it-as I think-that 12 is the best-case scenario, and that they didn't want to give an even more conservative estimate? For all intents Volquez is done for 2010, but he's young enough to correct his mechanics and come back well. The Reds are also keeping a close eye on Scott Rolen after taking a hard shot to the head. He was held out since he was still having some symptoms. The team will continue to hold him out as long as symptoms are there, but they don't think he'll be out long.

Roy Oswalt (8/7)
Players always want to play. It's the job of the manager, the front office, and the medical staff to go past that desire and do not only what's right for the team, but what's needed for that player. Even for someone like Oswalt, someone who has done well pitching with pain in the past, the Astros can't let him go out there for his next start. But is the reason what you'd think? Probably not. Sources tell me that the team is going to hold Oswalt out for one start to make sure that "Oswalt's ready for the playoff push." Look, I'll agree that the Astros should be in win-now mode, but the decisions they're making don't seem like desperation, just delusion. Oswalt's health in both the short and long term is key to this franchise, and a week shouldn't make or break either.

Chad Billingsley
I got a bunch of tweets and texts while sitting at the Rangers game last night, all dealing with the theme of Billingsley's knee. Most thought he'd hyperextended it, while some tried to tie it together with his broken leg from the offseason. It turns out that it was a simple cramp, one that looked very awkward over his last few batters, which made Joe Torre pull him. I'll once again question Billingsley's conditioning here, but it was a very hot night. The key here is that if it was just a cramp, he should show none of that exaggerated pull-off that he was using, one that puts more stress on his shoulder, the next time out.

Ian Kinsler (8/12)
Kinsler hits the DL with a hamstring strain almost exactly at the point of the season that he went down last year. This year's not the same, however, in terms of where he was injured, or the injury's severity. In fact, there was no real setback here, just the knowledge that Kinsler's not the kind of player who can dial it back to make sure that he doesn't reinjure himself. In much the same way that Michael Young and Josh Hamilton play through pain, Kinsler's another in kind. Normally it's a good thing, but as I said with Oswalt, it's the team's responsibility to protect everyone's best interest, which is exactly what's happening here. Kinsler will come off when he's eligible late next week and may play a game or two in Frisco to get his timing back. In his absence, Omar Vizquel will remind us how much guile factors into the game, making plays like the "oops" play to erase Ichiro Suzuki on Sunday night.

Brandon Inge
I always have conflicting reactions when I see "new ways of treating" any condition in sports. First, I think "oh cool"... and then I worry. Inge is trying "new ways of treating" his patellar tendonitis, but it's really nothing more than when he's getting treatment. He's doing the same things, just after the game, giving him his normal pre-game routine to focus on baseball. Baseball players are creatures of habit, almost pure Skinnerians in their work. Inge's change will mean more long nights for him and the medical staff, but results are worth it. (For those that read about this Monday morning and e-mailed me about PRP, nope, it was not even considered.)

Mark Buehrle
Is perfect bad? No, not in any way, except in that it seems that no-hitters are more stressful. It's reasonable given the pressure and excitement that goes along with it. Curt Schilling and Bud Smith are recent examples of pitchers who had a great night and then suffered some consequences. Buehrle was absolutely perfect to a lot of batters in a row, so is that part of the reason that he's down a bit? I'll suggest that it's a large part of it. If you go back to the original PAP research, it states that fatigue leads to problems in the immediate three starts after a long outing.His perfect game (plus more the next time out) didn't involve a big pitch count, but that number's only a proxy for fatigue. Buehrle wasn't abused in any way, and I'm not suggesting that Ozzie Guillen should have handled him differently. I'm just saying that fatigue has a cost, and maybe so does perfection.

Quick Cuts:Jake Peavy's schedule is accelerating and there's a chance that he could be back in late August. If so, we'll know soon, as he'll need to be on a mound in the next ten days to hit that schedule. ... Nelson Cruz went down hard at the end of a tough Rangers loss. There's no news as I go to submit, so watch this one. ... Scott Downs heads back to the DL with the toe issue. ... Corey Hart will miss about a month after an appendectomy. ... Jeremy Bonderman will make a start at Triple-A Toledo on Tuesday. Say that three times fast. ... Billy Wagner made another rehab outing, and seems on track to return later this month. ... Gil Meche only lasted three-plus innings in his rehab start at Triple-A and was very wild. ... Troy Glaus now has a disc problem in his back as he continues to try and come back from a shoulder issue. The Cards aren't expecting any production from Glaus, though it's still possible he could return. ... Shane Victorino has a bruise on his knee, not in his knee. That's better and he should be back in a couple of days. ... Yankees überprospect Jesus Montero is done for the season with a broken finger, but he may be back in time for the Arizona Fall League. ... Edgar Gonzalez is still experiencing post-concussive symptoms and may be shut down as a precaution. ... Usually it's a 30-inning increase where I worry, but man, Clayton Kershaw seemed to really hit a wall at a 20-inning mark, losing complete control and composure. Let's see how he does his next time out, and facing that 30-inning mark. ... A bit of a tease here: Injuries don't cost as many wins as you'd expect, but injuries do crush teams in the wallet. GMs seem to get injuries, but owners don't. I'll have more on this soon.

The competition and schedule in ML is so much harder and it could be why we don't count the minor league innings very much. I think we should discount the minor league innings instead, but have no idea to what extend should we discount it.

That's my guess, but I'll be honest -- I don't like it. I've used translated innings and it didn't work. I'm working on something now and have pulled in some of the sharp knives, the guys that can do the hard math to try and do a big, full-on look. It's not going to be soon -- need a full year's data. Maybe it's a BP2010 piece?

Regarding Billingsley and his conditioning (or lack thereof): if anyone watched the game on Sunday, Chad was POURING sweat from the first pitch - I understand we're talking about Atlanta in the mid -Summer, but the poor kid looked like Patrick Ewing from the mid 90s out there.

Ichiro on first, Lopez batting. Pop up behind second, went back to catch it and Vizquel lets it drop at his feet. Throws to second for the force, swapping a slower runner for Ichiro. Really heady baseball play.

Here's a question I've had for some time now. Why is it that players can get back from a surgery on their kneee just as fast as an appendectomy? It's a weight bearing joint that they run on and sees change in direction stresses versus removing a useless item from the gut? What the delay in returning from the appendectomy from? Cutting thru muscle?

Any concern on Verlander's usage? If there was ever an opportunity to let him leave a game a bit early, it was last night after giving up 5 runds and 6 or 7 hits in the first inning. He pitched 8 innings.

Thing is, he wasn't struggling. The first was a little shaky, but could have ended earlier if it wasn't for a bad hop grounder that eluded Inge. And after that inning, he was smoking. He got stronger and stronger as the game went on, blowing high 90's heat (see the Markakis at-bat leading off the top of the 8th). He threw 84 strikes in 119 pitches, allowing only 3 hits after the 1st.
It was my first game at Comerica and I was impressed on two fronts - by Verlander's pitching and by the beautiful stadium (I live in Toronto)

Will: This seems like a chat question but I know you don't do those much anymore. Not an injury per se, but would love your take. There's a Denver Post story today that says Dexter Fowler will be somewhat limited due to back pain arising from a "growth spurt". Dex has grown 1 inch in the "past few months" - and he's 23! Not to mention he was already 6-4. How unusual is this and does it tell us anything?

Regarding Mark Buehrle, after his perfect game, he faced the Twins in Minnesota, where they average 5.4 runs/game, then the Yankees in Chicago, and the Yankees average 5.5 runs/game on the road, so it could just be that he faced two good offenses.